Day 3 : February 28, 2018

Keynote Forum

Biography:

Kim Roberts is Chief Executive of the UK national charity, HENRY. For the last 10 years HENRY has been transforming traditional approaches to obesity prevention, working in partnership with public health departments and academic partners across the UK to develop and test research-based practical interventions to tackle child obesity in the preschool years.

Abstract:

Almost a quarter of children aged 4-5 are overweight and the prevalence of obesity currently stands at 9.6%. There is a clear need for intervention in the pre-school years and HENRY’s (Health, Exercise, Nutrition for the Really Young) parent-targeted approach has shown consistently positive results when delivered by trained staff. This study aimed to test whether the HENRY Healthy Families programme was also effective in improving eating behaviour and habits, physical activity, parenting confidence to provide a healthy lifestyle and emotional wellbeing when delivered by trained volunteer mentors. Further analysis explored differences in outcomes from programmes delivered by volunteers or project staff. The programme was delivered one-to-one over 8 weekly sessions of one hour, with outcomes measured at baseline, post-programme, and at 6 months follow-up. Parents (N = 87) reported improvements in parenting confidence, parent and child emotional wellbeing, some family eating behaviours, and consumption of fruit and veg (parent and child) and water (child only), but not in physical activity or consumption of certain snack items. Some of these improvements were maintained at 6 months follow-up. There were no differences in outcomes from programmes delivered by trained volunteers (n = 68) or project staff (n = 18). Parents who received the programme from volunteers reported comparable gains in key health indicators of parents and children to those delivered by project staff, providing tentative evidence that these programmes can be successfully scaled up with delivery by volunteer mentors. Future research should test this model on a larger scale.

Keynote Forum

Biography:

Dr. Subhi Badarni has been graduated from Hadassa Medical School, the Hebrew University in Jerusalem, majoring in social and community medicine and public health, Israel. He started working at the Health Ministry in Acre, as head of health education and promotion department. Today, he works as a lecturer of health promotion at Sakhnin College and health researcher.

Abstract:

The nutrition condition among school pupils in the world has gotten worse to an epidemic situation. The obesity rate is 25% in the developed countries while among Arab pupils in Israel, it has risen by 35%. Only 23% of the pupils perform physical activities weekly. The objectives of this article are raising awareness and changing behavior among pupils and their parents about healthy nutrition and the importance of physical activity; reducing 40% of obesity among pupils; increasing the physical activities by 60% on a weekly basis among school pupils. Achieving these objectives requires conducting Body Mass Index (B.M.I) survey by skilled nurses for all school pupils before and after the health promotion invention program at school; conducting a needs assessment study; a questionnaire. School should continue using the program for the next 5 years in such a way that would make other schools use it. In addition, more community volunteers, decision makers and sponsors, as well as the school community, should be recruited as part of the program.

Keynote Forum

Biography:

Obesity is a common and increasing problem in modern society. According to WHO, there are 1.8 bln. people in the world who are either overweight or obese. The growing concern is the increasing number of overweight children as these children and adolescents have a strong predictive pattern for the development of overweight and obesity in adulthood.

Pathogenic pattern underlying obesity is associated with increased food intake and sedentary lifestyle. There are many theories providing explanation for this pattern: the idea of disturbances in the regulation of energy balance, or the role of intestinal microbiota. One of the causes of obesity is dysfunction of hypothalamic structures that results in increased appetite and eating disorders. Evidence suggests the effectiveness of transcranial techniques such as transcranial magnetic therapy (TMT) with alternating magnetic field. This is because influences of TMT occur at the hypothalamic level. The aim of the given study was to assess the effectiveness of TMT in management of eating disorder and in the possibility of weight loss in obese adolescents. 80 patients aged 14-18 with second and third degrees of obesity were examined. The 5-score based questionnaire was developed to subjectively assess food craving. Indicators of lipid and carbohydrate metabolism were assessed as well as hormone panel, and the results of EEG and CIG. TMT with alternating magnetic field, which scan rate was 1-12 Hz, was performed using the device “AMO-ATOS” (OOO“TRIMA”, Saratov). Results: the children complained about increased appetite and blood pressure. Blood biochemical analysis findings showed elevated levels of cholesterol, triglyceride, LDL, and immunoreactive insulin. Some children had elevated levels of TSH and cortisol. CIG results showed changes in brain biological and electrical activity and marked prevalence of activity of subcortical nerve centers (ASNC) in 77 % of adolescents. A month after the treatment with TMT stimulation the number of adolescents with normal frequency and α- and B-rhythm range increased by 2-2.5 times, centralization index decreased by 2 times which enabled to decrease hunger, craving for food and the loss body weight by 36%.Thus, TMT stimulation resulted in normal bioelectrogenesis of the brain and endocrine profile. Alongside normalization of metabolism and body weight loss were observed.

Jens Byskov

Co-Chair

Subhi Badarni

Session Introduction

Biography:

Girish Sehgal, has had a remarkable career in the hospitality industry working in Maldives, USA, Bahamas, Canada, and India. Girish’s career began with Kempinski Hotels, moved to Four Seasons Hotel and Resorts, thereafter, joined Taj Hotels Resorts and Palaces as General Manager at various luxury Taj Hotel properties, under his aegis the teams received several prestigious international awards and accolades. In 2016 took up the role of CEO and MD of FASSCO, enticed by FASSCO’s vision of bringing hospitality into healthcare. Girish completed his Master's degree in International Hospitality and Services Industries Management from Glion Institute of Higher Education, Montreux Switzerland.

Abstract:

Knowing what’s on the plate in front of us is such a fundamental assumption that we don’t even think about it, but is a daily mystery for many people on texture-modified diets.

Innovation in texture-modified food services commenced with molecular cuisine, which involves understanding of both the physical and chemical processes that take place in cooking. At Food & Allied Support Services Corporation (FASSCO), we are applying this science through a range of products and techniques that replace unappetising scoops of puréed food items and thickened liquids with food and beverage solutions that restore dignity and the simple pleasures of a meal.

For our healthcare clients whose recovery may be dependent on holistic approach, including nutritional and mental health aspects, we know the dining experience requires so much more than simply nutritious food. We also know that the love of food begins at an early age and doesn’t diminish with age. Neither does it diminish when we are unwell; in fact there is often a heightened awareness and impact of sensory aspects such as smell, sigh, texture and taste.

FASSCO International has partnered with Chef Tibor Paller, an industry recognised expert in texture-modified food solutions for the healthcare industry.

We understand food is an essential element in the healing process of the patient, hence we ask ourselves and you, ‘Do We Want To Provide Food or Do We Want Our Patients to Eat?’

Biography:

Abstract:

Background: Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of both acute and chronic liver disease. Symptoms of HE can include confusion, disorientation and poor coordination. A general consensus exists that the synergistic effects of excess ammonia and inflammation cause astrocyte swelling and cerebral edema; however, the precise molecular mechanisms that lead to these morphological changes in the brain are unclear. Cerebral edema occurs to some degree in all patients with HE, regardless of its grade, and could underlie the pathogenesis of this disorder. The different grades of HE can be diagnosed by a number of investigations, including neuropsychometric tests (such as the psychometric hepatic encephalopathy score), brain imaging and clinical scales (such as the West Haven criteria). HE is best managed by excluding other possible causes of encephalopathy alongside identifying and the precipitating cause and confirming the diagnosis by a positive response to empiric treatment. Empiric therapy for HE is largely based on the principle of reducing the production and absorption of ammonia in the gut through the administration of pharmacological agents such as rifaximin and lactulose.

Aim of the study: To study HE in relation to the causes of liver disease, the common risk factors, the effect of the comorbidity in the outcome and mortality among the patients with HE.

Material and methods: This was hospital-based, non-interventional, descriptive, cohort study, conducted in Ibnsina hospital, from January 2010 tells May 2011.The study enrolled 76 patients admitted to the medical ward. All patients were diagnosed with HE due to liver disease.

Results: Total number of patients was 76, male constituted 62 patients (81.5%). The ages of the patients between 13 and 84 years old, most of the patient from Gezira state (25%), regarding the causes of liver disease the HBV is found to be the most common cause (36.8%), followed by HCV (11.8%), clinically (59%) have impaired level of consciousness. Infection is the most common risk factor(54%), followed by electrolyte disturbance (42%).mortality one to three weeks following admission is (50%), Comatose patient is likely to die(87.5%), comorbidity like an infection(53.8%) in died patients, renal impairment(58.8%) were very frequent and affect the mortality.

Conclusion: This study concludes that HE is one of the most important and common complications of the chronic liver disease and associated with high mortality. The mortality tends to increase in the presence of comorbid conditions such as renal failure, infection and upper GIT bleeding. Early discover HE and early management can reduce the mortality.

Biography:

Abstract:

Malnutrition remains a major proxy determinant of child mortality common among under five children and account for about one-third of malnourished cases worldwide. This chronic condition is a severe public health problem in sub-Saharan Africa that requires continuous critical attention. This study explored maternal sensitive factors that are important in the etiology of malnutrition with urban slum setting. The study was conducted among 400 eligible households systematically samples at random. The analysis was based hierarchical regression with principal axis factoring for selective variables. Psychosocial indicators did not have any observable association with nutritional status. Seeking immediate medical attention from the nearest health facility (HSB-1) and Average duration of introducing a child to the first liquid in hours (FP-4) significantly reduced stunting. Clean my hands with running water and soap before feeding a child (FHP-1) significantly reduced stunting among other indicators. HSB-1 somehow increased stunting. Wasting was significantly reduced by HSB-1 but increased by consulting a private doctor to examine a child (HSB-3). Underweight had no association at all with all indicators of maternal factors except at crude odds ratio level where FHP-1and HSB-1 were somewhat associated with underweight. In conclusion, this study revealed that food hygiene practice, health-seeking behavior and feeding practice were all significant associates of stunting (p<0.05). Wasting was only associated with health-seeking behavior (p<0.05) while underweight had an association with food hygiene practice and health-seeking behavior (p<0.05). However, it is noted that in these factor domains only selected indicator measures exhibited significant associations.

Biography:

Dr. Bashair Almutairi is Assistance Professor in the Medical Records Departement, College of Health Sciences, at PAAET, Kuwait. She has been Graduated from Health Information Management Department, College of Allied Health, Kuwait University, with the specialties including Health Information Management. Later on, she obtained her MSc. in Health Information System from the University of Pittsburgh and her Ph.D. in Health Information System from University College of London. Currently, she is working as Chairman of Medical Records Department, College of Health Sciences, Public Authority for Applied Education and Training, Kuwait

Abstract:

The use of electronic patient records improves healthcare quality for patients and increases the efficiency of clinics. The perceptions of clinicians are important for adopting such systems into routine practice. Our aim was to explore the perceptions of dentists in Kuwait about the use of electronic dental records. This cross-sectional national survey, 300 self-administered questionnaires were distributed to dentists working at randomly selected primary-health centers in Kuwait. The survey statements is about benefits, features and functionality of electronic records, as well as obstacles preventing their use. Multivariable Analysis was done using various tests’ in SPSS. Overall, the participants responded very positively, particularly on issues such as storage of radiographs (85%) and records (89%), sharing patient records with other dentists (96%), and the potential for improving medical histories (98%). The main obstacles to uptake were software/hardware issues (57%) and the need for technical training (55%) and maintenance (65%). Dentists recognize the need for electronic patient records to optimize the quality of patient care. They generally have positive attitudes towards electronic records, and most agree that accessing and sharing them with other healthcare providers is useful. They identified several obstacles to uptake, such as the need for technical support and training. Our findings indicate the potential for widespread adoption of electronic patient records in Kuwait for improving patient support and healthcare delivery. The only limitations to the study were the failure of some participants to respond to specific questions.

Biography:

Dr Rufaro Murebwa Chirambo graduated from the University of Zambia, School of Medicine with a Bachelor’s degree in Nursing, then did Masters in Public and consequently a Ph.D. in Public Health at the same University and she has been working at WHO in the Disease Prevention and Control unit, as well as an International Consultant and Technical Advisor. She is also a part-time Lecturer at the Copperbelt University, School of Medicine. Rufaro has her expertise in disease surveillance of vaccine-preventable diseases, monitoring, and evaluation, as well as immunizations.

Abstract:

Acute Flaccid Paralysis (AFP) surveillance was adopted by World Health Organization (WHO) following the World Health Assembly (WHA) Resolutions in May 1988, to monitor progress towards poliomyelitis eradication in all member countries. It was introduced in Zambia in 1993. Since then, health workers collect AFP surveillance data however; there is no documented evidence of the review of the performance of the system and epidemiological analysis of the data. The purpose of this study was to review performance of the AFP surveillance system between 2000 and 2009, discuss the epidemiological distribution of cases tested at the national polio laboratory in the period under review and identify components in the AFP surveillance system that require strengthening. A retrospective descriptive analysis was conducted on secondary AFP surveillance data for the period 2000-2009, consisting of all children aged <15years and performance evaluated using WHO-specified core AFP global surveillance indicators. During this period, a total of 1,452 cases were investigated. Completeness of data from case-based forms was very inadequate. The non-polio AFP rate ranged from 1.8 -3.3/100,000 and stool adequacy from 65% - 96%. There was low Non-Polio Enterovirus (NPENT) rate. The aim of the presentation is to show the performance of the AFP surveillance system and to describe the epidemiological patterns.

A high level of surveillance performance was achieved during this period, though there were a lot of gaps in the national AFP surveillance database. Improvement in the identified gaps could achieve optimal standards recommended by WHO and provide a good model for poliomyelitis eradication.

Biography:

Mr Tekchand is a PhD student doing research is on availability and accessibility of healthcare service from CSRD, Jawaharlal Nehru University, New Delhi, India.

Abstract:

Statement of the Problem: Rural population becomes more vulnerable when availabilities of health care facilities are concentrated in urban areas, non-functioning of primary health facilities, lack of basic medical staff and medicines make the situation worse. The overburden of population in Primary health institutions reduces the quality of healthcare services. This difference in available health facilities for rural population (share around 70%) and recommended Sub-centre and Primary Health Centre by Indian Public Health Standard (IPHS) 2012, will create challenges for the achievement of sustainable development goals and Indian National Health Policy 2017.

The objective of the study is to analyze the association between spatial availability of primary health care delivery system, reported morbidity and their treatment seeking behavior in Rajasthan.

Methodology: District Level Household & Facility Survey 2007-08 (DLHS-3), Annual Health Survey (AHS) 2013 in Rajasthan, Census of India 2011 and Ministry of Health & Family welfare reports have been used for data, which covered issues related to chronic disease, reproductive health and availability of healthcare facilities with socio-economic characteristics. Suitable statistical methods such as rate of prevalence, correlation coefficient, composite index, logistic regression and graphical representation using tables, diagrams and maps have been used for analysis.

Results: Districts with tribal population concentration show population pressure on Sub-Centre and PHC. Poor availability of basic infrastructure facilities and human resource in Sub-centres and PHCs. There are only 53% Sub-centre having Auxiliary Nurse Midwifery (ANM) and 11% having Male Health Worker (MHW). Respiratory, cardiovascular and Ear, Nose Throat (ENT) morbidities have been concentrated in only some districts of Rajasthan. Availability of primary health care facilities has a negative association with the reported illness among people. Therefore, the study will help to know the challenge in the goals of the national health policy 2017.

Biography:

Abstract:

Considerable evidence supports that increasing consumption of dietary fiber is associated with lower risk of obesity in adults.Although most of the proposed beneficial effects of fiber consumption have been attributed to viscous and gel-forming properties of soluble fiber, both soluble and insoluble fiber are strongly associated with reduced risk for obesity and overweight.

In total 100 women were included in the study.Survey questions were prepared to get details about the general characteristics of participants.Also, participants were asked to fill out a 3-day food consumption form and a 24-hour physical activity form to receive nutritional habits and physical activity information.Subsequently, all the food consumption of the participants were entered into the BEBIS program in order to calculate macro and micronutrient intakes.Statistical analyses were performed with SPSS software.Between-group differences for categorical variables were compared by using chi-square analysis. Pearson correlation test was used in order to determine the correlation of fiber intake and body composition.Fiber intakes of the participants were categorized and compared across tertile group.One group was categorized as ‘low consumers’ (below 25g/day of fiber intake) one was ‘moderate consumers’ (between 25-40g/day) and the third group was ‘high consumers’ group(<40g/day). Results of this study indicated that participants who have consumed moderate amount of fiber is associated with lower body mass index, body weight and body fat.In terms of fiber intake and body composition association, results showed that there was a statistically significant difference between low consumer and moderate consumer group (p<0,05), while there wasn’t any statistical difference between moderate consumer and high consumer group (p>0,05).In view of the fact that, when mean dietary fiber intake is about as advised (25-40g/day) can be protective of overweight/obesity.Higher than the recommended amount is not meaning that it may be more protective of overweight/obesity.Results of this study indicated that moderate fiber intake is inversely associated with body weight, BMI and body fat.

Biography:

Dr. Aparna Jain is an upcoming public health specialist from India. Presently pursuing junior residency for the degree of MD from the Department of Community Medicine and Public Health, King George’s Medical University, Uttar Pradesh, Lucknow, India.

Abstract:

Background: Autism is a neurodevelopmental disorder with core features of impaired social interaction, impaired communication, and restricted and repetitive interests and activities. Parents of children with Autistic Disorder may find themselves burdened with a lifelong responsibility of caring for their children and diminished attention to their own health. Other than this, lack of knowledge about autism, lack of treatment, and if treatment is available it is unaffordable, adds on the stress. This leads to deterioration of quality of life of parents in several domains like affected social life, increased physical, emotional and psychological stress, family clashes and affected married life.

Objectives: To study the Quality of Life of Principal Caregivers of Autistic children and adolescents visiting health facilities in Lucknow city.

Method: Purposive sampling method was used. The sample included 90 principal caregivers (aged < 60 years) of autistic children and adolescents aged 3 to 19 years and diagnosed with autism, attending government and private health facilities providing treatment for autism in Lucknow, Uttar Pradesh, India.

Result: The quality of life of principal caregivers was found to be influenced most in the physical health domain (with least score). The caregivers with good score in environmental health domain had better knowledge regarding Autism. Place of Residence influenced the Psychological and Environmental health of principal caregivers. The predictors of quality of life of principal caregivers were Type of family and Knowledge regarding child’s problem.

Conclusion and Recommendations: Knowledge regarding Autism predicted the overall quality of life of principal caregivers. Thus, there is an immense need of increasing awareness through IEC materials, Mass Media, discussions etc. regarding Autism. The caregivers should be counselled about the importance of joint families in improving their quality of life.

Biography:

Nandeeta Samad graduated from Institute of Nutrition and Food Science, University of Dhaka, Bangladesh. She obtained master’s degree in Nutrition and Food Science from the same institute of University of Dhaka. Later on, she started working as Research Associate in South Asia Institute for Social Transformation (SAIST). Her contribution in Public Health research and community development brought her recognition of Associate Fellow at Royal Commonwealth Society, United Kingdom and Fellow at South Asian Youth Society (SAYS). She has several articles published in different international journals and portals. Presently, she is pursuing MSc Public Health at University of East London, United Kingdom.

Abstract:

Food Taboo – An Unmasked Threat to Healthy Pregnancy: A Study among Pregnant Mothers Living in Slums of Dhaka, Bangladesh aimed to investigate the prevalent food taboos and misconception practiced by the underprivileged community of the capital of Bangladesh. A six-month long cross-sectional study had some crucial findings which proved to be significant public health challenges. The most common food taboos indicated that twin fruits or vegetables would cause twin pregnancy, which has no scientific verification. Other taboos focussing plant food items were also prevalent among them. It was surprising that some mothers believed eating fish during pregnancy will lead the child having scales and fish like head and salted or dried fishes consumption may lead to the birth of dull-headed baby. Even they believed that milk production may be hindered by prawn. Their meat consumption was found to be limited sometimes with the belief that eating duck meat may lead the baby having harsh voice and shockingly eggs were said to create psychological problems in baby. During the interview, some mothers denied to feed their babies colostrum as they considered that colostrum might upset infant’s stomach. Thus protein-rich foods of high bioavailability was less consumed by the majority of the studied population. Where medical science and pharmacology are advancing, the existence of superstitions, food taboos and misconceptions, illiteracy, insufficient nutrition education and untrained community health workers are the prominent barriers to improving public health and achieving Sustainable Development Goals (SDGs) in the underprivileged and deprived communities of developing countries like Bangladesh.

Biography:

Dr Abhishek Kumar Sinha, graduated from JSS Medical College, Mysuru Under Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka India in the year 2009. At present, He is doing my post graduation (M.D) from JSS University, Mysuru, Karnataka, India and working in the capacity of final year postgraduate cum tutor. He is also secretary of All India Federation of Government Doctors Association, New Delhi, India. He has been associated with the government of Bihar, India, as a medical officer from the year 2010 to 2015. He qualified in emergency management of obstetrics care backed by fellowship in intensive care medicine from Hyderabad, Telangana, India. He has worked as General Secretary of Contract Doctor’s Association, Bihar, India from 2011 to 2015. He is a life member of Indian Medical Association, Indian Epilepsy Association, Indian Association of Preventive and Social Medicine (IAPSM) and also Indian Public Health Association. He is also a member of International Epidemiological Association.

Abstract:

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance onset or recognition during pregnancy.GDM has implications on the mother and child. Effective management of gestational diabetes reduces the complications during pregnancy and on the baby. Thus screening and diagnosis of GDM is an important public health issue. Hence this community-based study was planned to ascertain the prevalence and its associated factors of GDM through spatial analysis in Mysuru.

Objectives:

To estimate the prevalence of GDM among women in Mysuru,

To assess the factors associated with GDM

To visualize the spatial differences in prevalence and factors associated with GDM.

Methods: A cross-sectional study was carried out in Mysuru district of Karnataka in June 2016 to July 2017. Pregnant women in 24 to 28 weeks gestation attending the ANC clinic at PHCs of Mysuru district were included in the study. A total of 600 antenatal women were included in the present study. Diagnosis of GDM was based on 2 hours 75 grams post glucose value ≥ 140 mg/dl. Statistical tests used were Chi-square test and Student's t-test.

Results & Conclusion: In the present study overall GDM prevalence was 13.5%. The incidence of GDM was highest (16.5%) in the Periyapatna taluk and lowest (11.0%) in the K. R. Nagar taluk of Mysuru district. Increasing age and BMI were significantly associated with GDM. Majority of the GDM women were homemakers and belonged to below poverty line families.

Biography:

Akua Nyamekye Darko is a young motivated researcher who has recently completed her masters in International Community Health, Faculty of Medicine, University of Oslo Her research interest is in the area of type 2 diabetes prevention, migrant health, non-communicable disease in general. She aims to further her research on interventions aimed at disease prevention.

Abstract:

Research has shown that physical activity and dietary interventions have the potential to reduce the risk of type-2 diabetes among the South Asian population. Nevertheless, little is known about the effectiveness of these interventions and contents of the interventions that contribute to the results attained. This study is, therefore, a review of the evidence available on the effectiveness of these interventions on the risk of T2D. Four databases were searched for randomized control trials published from 1900-2016. The review included interventions that comprised of both awareness creation and practical demonstrations of lifestyle changes necessary for a healthy living. After a careful search of literature and quality assessment, this review conducted a narrative synthesis of results obtained. Four studies were identified. Three focused on both dietary and physical activity interventions and one on only physical activity. All the studies were conducted outside the South Asian continent. Two of the studies reported a reduction in weight after the intervention period. One of these studies focused mainly on intensive physical exercise for male adults (p-value less than 0.01 after five months). The other study focused on physical activity and home-based dietician visits and consultations involving the family cook and family members (p-value: 0.0076). All the four studies were culturally adapted to suit the South Asian population. Some of these adaptations helped to increase participation and retention through the intervention process. The evidence on the effectiveness of the dietary and physical activity interventions in reducing weight among South Asians is inconclusive. The effectiveness of these interventions in reducing the risk of type-2 diabetes among South Asians is most likely possible amidst various cultural adaptations. Researchers of future lifestyle interventions for South Asians are recommended to, therefore, focus developing interventions that are culturally adapted from recruitment to follow up.

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